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Department of Neurology

 

Milestone 11: Systemic Disease — Patient Care

 

Specifics about each Level and each Item:  What you do you need to know:
 

Level 2

• Diagnose and management of common systemic diseases

a. Neurologic complications of ETOH abuse

1. Withdrawal seizures
2. Encephalopathy (Wernicke syndrome)
3. The role of vitamins, glucose, etc. in treatment
4. Associated disorders: meningitis, head trauma
5. Delirium tremens

b. Neurologic complications of diabetes mellitus

1. Hypoglycemia, hyperglycemia in an ER setting
2. Polyneuropathy, mononeuropathy – initial treatment of pain of polyneuropathy

c. Basic complications of renal failure
d. Neurologic manifestations of drug overdose in the ER setting, particularly cocaine and heroin
e. Syncope versus epileptic seizures (witnessed and unwitnessed)


Level 3

• Diagnosis and management of uncommon manifestations of hyperglycemia (nonketotic hyperglycemic states)

a. Focal seizures including focal status and other focal motor activity
b. Hemiparesis

• Diagnosis and management of common rheumatologic disorders

a. Polymyalgia rheumatica/temporal arteritis
b. SLE: meningeal complication, cerebritis, symptoms such as headache and epilepsy.
c. Antiphospholipid syndrome

• Diagnosis and management of unusual PNS syndromes secondary to diabetes mellitus

a. Cranial mononeuropathies, particularly III, IV, VI
b. Diabetic amyotrophy, polyradiculopathy
c. Limb mononeuropathies
d. Dysautonomias

• Diagnosis and manage the neurological complications of sarcoid

• Diagnosis and management of B12 deficiencies


Level 4 

• Diagnosis and management of the neurologic manifestations of endocrine disorders


a. Thyroid disease

1. Hyperthyroidism: tremor, Graves ophthalmopathy, cognitive changes, myopathy
2. Hypothyroidism: mental changes, myopathy

b. Parathyroid disorders
c. Adrenal gland disorders: pheochromocytoma
d. Pituitary disease

• Diagnosis and management of unusual connective tissue disorders

a. Behcet’s disease
b. Polyarteritis nodosa

• Diagnosis and treatment of the neurologic manifestations of proliferative hematologic disorders

a. Plasma cell dyscrasias
b. Lymphomas
c. CNS and PNS involvement


Resources for each Level:

Level 2 Resources:

• Introduction to Neurology Summer Course

• Teaching rounds, general neurology inpatient service (and stroke service) in particular, consult service

• Case presentations to faculty in the Continuity Clinics at UHCMC and VAH Wade Park

• Attending CPC conference

• Selected case/disease oriented reading

a. Up-To-Date through the core library
b. Textbooks

1. Neurology in Clinical Practice
2. Merritt’s Textbook of Neurology
3. Harrison’s Principles of Internal Medicine
4. Self-reading


Level 3 Resources:

• Teaching rounds on general neurology inpatient teaching service

• Continuity Clinic, case presentations to and discussions with faculty attending

• Up-To-Date case/ disease oriented reading

• Selected Continuum journals

• Self-reading

• CPC, morbidity, mortality conference

• Selected grand rounds presentations


Level 4 Resources